Atlas of Office Based Andrology Procedures

139 Pages·2017·7.5 MB·English

by  John P. Mulhall

Atlas of Offi ce
Based Andrology
Procedures
John P. Mulhall
Lawrence C. Jenkins
Editors
123
Atlas of Offi ce Based Andrology Procedures

John P. Mulhall • Lawrence C. Jenkins
Editors
Atlas of Offi ce Based
Andrology Procedures
Editors
John P. Mulhall, MD, MSc, FECSM, FACS Lawrence C. Jenkins, MD, MBA
Director, Sexual & Reproductive Medicine Fellow, Sexual & Reproductive Medicine
Program Program
Section of Urology Section of Urology
Department of Surgery Department of Surgery
Memorial Sloan Kettering Cancer Center Memorial Sloan Kettering Cancer Center
New York , NY , USA New York , NY , USA
ISBN 978-3-319-42176-6 ISBN 978-3-319-42178-0 (eBook)
DOI 10.1007/978-3-319-42178-0
Library of Congress Control Number: 2016951719
© Springer International Publishing Switzerland 2017
T his work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of
the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation,
broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information
storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology
now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication
does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant
protective laws and regulations and therefore free for general use.
T he publisher, the authors and the editors are safe to assume that the advice and information in this book
are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the
editors give a warranty, express or implied, with respect to the material contained herein or for any errors
or omissions that may have been made.
Printed on acid-free paper
This Springer imprint is published by Springer Nature
The registered company is Springer International Publishing AG Switzerland
Pref ace
A ndrology is the medical specialty that deals with male health, especially as it per-
tains to problems of the male sexual and reproductive system. Andrological issues
in urologic practice and indeed in general medical practice are commonly encoun-
tered, yet perplexing for many clinicians. Sexual dysfunction is gaining increased
attention in the media as it becomes more acceptable to discuss previously taboo
topics. These are often topics that men suffered from but either did not know to ask
or were too uncomfortable to ask with their physician. Sexual dysfunction is a com-
mon problem that can have a major impact on a patient’s quality of life, including
their relationship and treatment satisfaction.
There is an increasing trend towards more medical care being delivered in the
offi ce setting rather than in an operating room. Offi ce-based andrology procedures
are more common than other areas of urology but yet not as well trained during
urology residency training. The increasing pressure of duty hours on urology resi-
dency training leaves residents often lacking comfort with these procedures.
The purpose of this text is to act as a resource to aid andrology practitioners,
including physicians, nurse practitioners/physician assistants, clinical trainees,
nurses, medical assistants, and others, who perform or assist in-offi ce andrology pro-
cedures. We tried to cover the most common procedures within a typical andrology
offi ce practice. However, some procedures were excluded because they are not very
common in an offi ce setting. We hope this book will be found useful to those who
have had no specifi c andrology training and to those who are simply out of practice.
New York, NY John P. Mulhall
New York, NY Lawrence C. Jenkins
v

Contents
1 Focused Genital Exam ............................................................................ 1
John P. Mulhall and Lawrence C. Jenkins
2 Biothesiometry ......................................................................................... 9
John P. Mulhall and Lawrence C. Jenkins
3 Nocturnal Penile Tumescence ................................................................ 15
John P. Mulhall and Lawrence C. Jenkins
4 Penile Block ............................................................................................. 19
John P. Mulhall and Lawrence C. Jenkins
5 Spermatic Cord Block ............................................................................ 27
John P. Mulhall and Lawrence C. Jenkins
6 Penile Duplex Doppler Ultrasonography .............................................. 31
John P. Mulhall and Lawrence C. Jenkins
7 Penile Deformity Assessment ................................................................. 47
John P. Mulhall and Lawrence C. Jenkins
8 No-Scalpel Vasectomy ............................................................................. 55
Kelly A. Chiles and Marc Goldstein
9 Nonsurgical Sperm Retrieval ................................................................. 63
John P. Mulhall and Lawrence C. Jenkins
10 Subcutaneous Testosterone Pellet Insertion ......................................... 67
David Ray Garcia
11 Intralesional Collagenase Injection ....................................................... 79
John P. Mulhall and Lawrence C. Jenkins
12 Intralesional Verapamil .......................................................................... 87
John P. Mulhall and Lawrence C. Jenkins
vii
viii Contents
13 Intramuscular Testosterone Training .................................................... 97
Natalie C. Wolchasty
14 Vacuum Erection Device Training ......................................................... 103
John P. Mulhall and Lawrence C. Jenkins
15 Penile Traction Device Training............................................................. 109
John P. Mulhall and Lawrence C. Jenkins
16 Intraurethral Alprostadil Training ........................................................ 113
John P. Mulhall and Lawrence C. Jenkins
17 Intracavernosal Injection Training ....................................................... 117
Joseph B. Narus
18 Office Management of Prolonged Erection/Priapism .......................... 129
John P. Mulhall and Lawrence C. Jenkins
Index ................................................................................................................. 135
Contributors
Kelly A. Chiles , MD, MSc George Washington University , Washington , DC , USA
David Ray Garcia Male Sexual and Reproductive Medicine Program , Memorial
Sloan Kettering Cancer Center , New York , NY , USA
Marc Goldstein , MD, DSc (Hon.), FACS Cornell Institute for Reproductive
Medicine, Weill Cornell Medical College of Cornell University , New York-
Presbyterian Hospital/Weill Cornell Medical Center , New York , NY , USA
Lawrence C. Jenkins , MD, MBA D epartment of Surgery, Section of Urology,
Memorial Sloan Kettering Cancer Center , New York , NY , USA
John P. Mulhall , MD, MSc, FECSM, FACS Department of Surgery, Section of
Urology , Memorial Sloan Kettering Cancer Center , New York , NY , USA
Joseph B. Narus , DNP, GNP-BC, ANP Male Sexual and Reproductive Medicine
Program, Memorial Sloan Kettering Cancer Center , New York , NY , USA
Natalie C. Wolchasty , MS, AGACNP-BC Male Sexual and Reproductive
Medicine Program, Memorial Sloan Kettering Cancer Center , New York , NY , USA
ix